“Funding certainty is critical in the health sector, and only the Coalition has a plan to return certainty to Health.”
Press release Peter Dutton Opposition spokesperson Health
The recent funding announcements from Minister Plibersek was too little, too late.
NOTE: This press release provided for the information of NACCHO members and stakeholders but not endorsed in anyway by NACCHO
More than that, they come from a Minister with a track-record of generating huge funding uncertainty in Health by making gung-ho decisions and breaking promises.
This is the Minister that slashed $1.6 billion from public hospital services without notice and without consultation. This is the Minister that cut funding retrospectively for services that had been provided, causing hospitals to cancel surgeries and close beds.
This year alone, Victoria has lost another $100 million and New South Wales $144 million compared to what was proposed in the 2012 Budget.
“Tanya Plibersek has consistently betrayed the trust of the medical profession and the Australian people when it comes to health funding,” Mr Dutton said.
“Funding certainty is critical in the health sector, and only the Coalition has a plan to return certainty to Health.”
Not content with creating chaos around hospital funding, Labor has also ripped $4 billion out of private health insurance rebates despite promising never to do so. This decision is forcing up premiums for Australians struggling to pay their cover and putting more pressure on Australia’s public hospitals.
“There is no reason for Australians to trust Labor to honour its health promises. History has shown that you cannot trust this government with Health and Australian patients have paid the price,” Mr Dutton said.
Study author Dr Andrew Black said a broader trial was needed to investigate whether it was feasible to have subsidised healthy food programs in Australia.
“The program could be adapted to target low-income families more generally,” Dr Black and his co-authors wrote.
But Dr Black, who is a general practitioner with a NSW Aboriginal health service and a fellow at the University of South Australia, said the proportion of children with iron deficiency and anaemia did not change.
The study involved children from 55 families who were aged under 18 and lived in northern NSW.
Each family was given a weekly box of subsidised fruit and vegetables, valued at $40 and nutritional information and recipes were provided to families.
A separate study published in the same journal found the health and behaviour of Aboriginal and Torres Straight Islander children in urban areas may be adversely affected by their high-levels of exposure to stressful events.
The study conducted between 2007 and 2010 at a Brisbane indigenous health service found that of 344 indigenous children aged 14 years or under about half had experienced a stressful event in their lives.
There was a strong association between those events and a history of ear and skin infections and parental or carer concerns about the child’s behaviour, the study says.
Eleven per cent of study participants had witnessed domestic violence, while 10 per cent had experienced it personally.
“The risk of not addressing both the causes and the effects of childhood exposure to stressful events is that the disparity between indigenous and non-indigenous Australians is unlikely to improve,” the study authors wrote.
Some suggestions for how researchers and health services might do a better job of engaging with Aboriginal patients and communities have come from a research project spanning rural, regional and remote NSW.
The suggestions include taking time to develop trust and relationships (including with community members outside of the health sector), recruiting Aboriginal staff, and engaging patients and communities through art and social media.
The NHMRC-funded Gomeroi gaaynggal program recruits Aboriginal women in early pregnancy and monitors their health and that of their infants throughout pregnancy. It aims to promote the early detection, diagnosis and prevention of diabetes and kidney disease.
Work began on setting up the program in 2006, recognising that many Aboriginal women are deeply mistrustful of mainstream pregnancy-related healthcare services, and this contributes to low uptake of antenatal care.
Sharing some strategies that work for Aboriginal health
Lynsey Brown writes:
Based on their experiences in Walgett (NSW) and other regional, rural and remote Aboriginal communities, Dr Kym Rae and colleagues describe strategies to improve recruitment and retention of Aboriginal people in research and antenatal programs.
The lessons learnt stem from the NHMRC-funded Gomeroi gaaynggal program, which investigates health issues across pregnancy and the post-natal period.
The Gomeroi gaaynggal team also works in partnership with the Aboriginal community and a range of health service providers to deliver an ArtsHealth program that addresses health literacy and service use.
The authors describe key strategies for recruitment and retention that can be applied across diverse regions.
Promoting both ownership and engagement, they note how community consultation must occur across multiple levels. For example, when establishing a health service, it is important to include conversations with not only health professionals but also organisations and individuals working in different areas across a range of social determinants of health (eg, housing, education, justice system), and particularly engaging with local community Elders.
It is this open and trusting dialogue that enables partnerships between researchers, clinicians and communities.
Community consultation is a step towards building trust, which is necessary between researchers and the community, and between research teams and partner organisations. However, trust takes time.
The authors describe prioritising recruitment of Aboriginal staff to enable open discussions, friendships and a supportive mentored environment, which helps this trust and sense of collaboration to develop.
The use of new technologies (in areas with adequate internet connectivity) is also discussed in detail. Social media such as Facebook can be beneficial in establishing connections, maintaining contact, keeping up-to-date with developments, providing opportunity for private emails, and encouraging communication at less cost than a phone call.
The importance of addressing local needs is emphasised, with the authors identifying successful recruitment and retention strategies in different areas.
For regional areas, provision of food and transport vouchers reduces costs for families travelling to health services. Further, Aboriginal staff spend time liaising closely with community members and health services staff.
In rural areas arranging transport and improving local access to services are key strategies. Facebook is also particularly valuable in promoting connection between the program and participants in this space.
Additionally, the authors highlight the benefits of requesting details of three contact people for each participant, to enable connection with families who often change residences.
In the remote region, the key factor is collaboration between the research team and the local Aboriginal Medical Service – with co-located offices and matching uniforms promoting an ongoing partnership.
Despite centres in different locations determining their own approach, it seems the generated strategies are applicable to other health professionals working to close the gap.
• Lynsey Brown is Research Associate, PHC RIS
• Rae K, Weatherall L, Hollebone K, Apen K, McLean M, Blackwell C, et al. (2013). Developing research in partnership with Aboriginal communities – strategies for improving recruitment and retention. Rural and Remote Health 13: 2255. (Online)
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To promote the benefits of working and training in an Aboriginal Medical Service (AMS), Pius X AMS in Moree, Armajun AMS in Inverell and local general practice training provider, GP Synergy, have come together to develop a video showcasing the AMS training experience to GP registrars.
Across the country, many AMS facilities are involved in the education and training of GP registrars, who are qualified doctors undertaking specialist training in the field of general practice.
The general practice training program requires GP registrars to undertake training in a variety of hospital and community based settings, and this can include training in accredited AMS facilities.
To encourage more GP registrars to consider undertaking part of their training in a rural AMS facility, GP Synergy approached Armajun AMS and Pius X AMS to develop a promotional video showcasing the benefits of working and training in an AMS.
The video features interviews with GP registrars who have undertaken their training in the facilities, as well as interviews with GPs and AMS staff about their AMS experience.
“We wanted to be able to explain to GP registrars the benefits of training in a rural AMS and felt the best way to do this was for the registrars and staff to share their own personal AMS experiences,” said GP Synergy CEO John Oldfield.
Both AMS facilities were happy to take part in the initiative.
“Our involvement in the training program has shown that GP registrars training in AMS facilities can contribute enormously to the primary care health provision for local Aboriginal communities,” Said Armajun AMS CEO Debbie McCowen.
“We are happy to support any initiative that seeks to increase the numbers of GP registrars training in AMS facilities,” she said.
Acting CEO Ray Dennison from Pius X AMS agrees.
“We have found being involved in training GP registrars invaluable,” Ray Dennison.
“Our local community has benefited from improved access to primary health care and it has been a positive two way learning experience. We have learnt as much from the registrar as they have from working with us,” she said.
CEO John Oldfield said the video provides a positive and realistic account of what registrars could expect working in an AMS.
“We hope the video encourages more GP registrars to undertake part of their GP training in an AMS, not just in New England/Northwest NSW, but anywhere in Australia,” he said.
The HSP is a professional development program for doctors working in the NSW public health system with at least two years of clinical postgraduate experience and not currently participating in a specialist vocational training program.
This group includes Career Medical Officers, multi-skilled Medical Officers, Senior Resident Medical Officers, Hospitalists and GP Visiting Medical Officers.
The curriculum provides a framework for the purpose of improving the health of Aboriginal people and communities.
The module development process was led by a group consisting of an Aboriginal health director, an Aboriginal health educator, non-specialist doctors with experience in working with Aboriginal patients and communities in metropolitan, regional and rural areas, and a curriculum writer.
The process was collaborative, consultative and an immensely enjoyable one according to Clinical Chair of the HSP and module development team member, Dr Simon Leslie.
“Collaborating with Aboriginal colleagues and fellow clinicians to explore and understand the social determinants of health inequity in the process of developing a curriculum in Aboriginal Health was an inspiring and rewarding experience,” said Dr Leslie.
Regular working group meetings provided a forum for team members to share different perspectives, expertise and knowledge.
“Although our curriculum is only one small step towards closing the gap, I regard my participation as an honour and privilege; a true highlight of my professional career. More than anything I enjoyed the humour, passion and down to earth nature of my new Aboriginal friends and to have earned their respect was the highest of rewards.”
The South East Koori Men’s Facilitators Network in NSW was recently established to achieve a major priority in Aboriginal health.
That is, getting Aboriginal and Torres Strait Islander Men’s health and thier social and emotional well being back to what it once was.
Dwayne Bannon -Harrison on of the organisers said that the network may have had had diversity in culture and communities however there was connectedness,need and oneness “for our mob tobring the Warrior back. ”
The network pictured above gathered recently at the South Coast Medical Service Aboriginal Corporation (SCMSAC) , Regional Services Outreach Office in Falls Creek near Nowra on the NSW South Coast.
There were Aboriginal health workers, AOD Workers, Men’s Group/program facilitators, Funding body representatives, ACCHO board members and mental health workers. The workers all work and are involved with Aboriginal & TSI Men’s Programs, coming from communities all over the South Coast and South East Region
This Network was initiated by SCMSAC –SU/SEWB workers Dwayne Bannon-Harrison & Nathan Deaves, the core focus of this network is to give support to the facilitators on how to establish and maintain Aboriginal Men’s Groups and importantly look after and support the SEWB of the facilitators.
The inaugural meeting was the transfer of knowledge and discussion in regards to Men’s health and SEWB was powerful and very proactive.
Key points and issues were recorded and the strategies on how to counteract those issues will be worked on at the next meeting at the Illawarra Koori Men’s Group Facility in Albion Park NSW on the 13th May 2013. The meetings will be taken all around the region so they can be co-facilitated and hosted by the communities in the network.
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